Last week, in the run-up to the passage of the health reform legislation, Secretary of Health and Human Services, Kathleen Sebelius, took a brief time-out from Washington politics to speak at the joint meeting of the American Society on Aging/National Council on Aging in Chicago. In part her remarks were intended to persuade the audience of aging services professionals that the legislative proposals would be good for older adults and the nation.

Obviously she cited the coverage of the uninsured and regulation of commercial insurance companies as advantages. But as shown in this video clip, she also talked about some of the perennial issues of concern to the Foundation around which our grantees have made such tremendous progress. Here are some key points:

  1. Hospital readmissions are human tragedies as well as a waste of resources, said Sebelius, clearly drawing upon last summer’s paper by Jencks, Williams, and Coleman.
  2. There are several good approaches to reducing rehospitalization. Although she spoke generally, I am sure she drew upon the Care Transitions work of Eric Coleman and Mary Naylor as well as the Society for Hospital Medicine’s Project BOOST.
  3. Team-based care and enhanced primary care for older adults can improve outcomes while avoiding waste and dangerous fragmentation. We were pleased to hear Sebelius reinforce these messages, which the foundation has supported with its Geriatric Interdisciplinary Team Training initiative, Geriatric Interdisciplinary Teams in Practice , Project IMPACT, Guided Care, and others.

As part of the legislation, which passed Sunday, March 21, in an historic vote in Congress, a variety of demonstrations and pilots are assigned to the new Center for Medicare and Medicaid Innovation (see section 3021) within CMS. This includes some $500 Million over five years (YES, MILLION!) for a Community-Based Care Transitions Program (Section 3026) that should radically scale up the work of Drs. Coleman and Naylor, as well as money for Community Health Teams to support the Patient-Centered Medical Home (Section 3502). This creates an opportunity to spread Guided Care and other excellent primary care models.

We will have to work hard to make these possibilities a reality, but right now, at least for today, I want to bask in the glory reflected from the Foundation’s grantees. It is not every day that their ideas and models for improved care of older adults are used as part of the rationale for national policy change more than 40 years in the making.